A4226 HCPCS code: Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week
A4226 is the HCPCS Level II code for supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week. Its Medicare coverage code is I (Not payable by Medicare): Medicare does not pay separately under this code; another code applies.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | I — Not payable by Medicare |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2020-01-01 |
| Last action effective | 2020-09-15 |
Related codes Medicare does pay
Medicare does not pay under A4226. These codes in the same A42 family carry a current DMEPOS fee:
- A4216 — Sterile water, saline and/or dextrose, diluent/flush, 10 ml: $0.53–$0.99
- A4217 — Sterile water/saline, 500 ml: $2.18–$4.93
What changed for A4226
- 2020-01-01: A4226 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code A4226?
A4226 is the HCPCS Level II code for supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week. Short descriptor: "Weekly supply maint cgs pump".
Does Medicare cover A4226?
Coverage code I — Not payable by Medicare. Medicare does not pay separately under this code; another code applies.
Which related codes does Medicare pay instead of A4226?
Codes in the same A42 family with a DMEPOS fee include A4216 ($0.53–$0.99), A4217 ($2.18–$4.93). Check the item matches the code's descriptor before billing.
Related A42 codes
- A4206 — Syringe with needle, sterile, 1 cc or less, each
- A4207 — Syringe with needle, sterile 2 cc, each
- A4208 — Syringe with needle, sterile 3 cc, each
- A4209 — Syringe with needle, sterile 5 cc or greater, each
- A4210 — Needle-free injection device, each
- A4211 — Supplies for self-administered injections
- A4212 — Non-coring needle or stylet with or without catheter
- A4213 — Syringe, sterile, 20 cc or greater, each
- A4215 — Needle, sterile, any size, each
- A4216 — Sterile water, saline and/or dextrose, diluent/flush, 10 ml ($0.53–$0.99)
- A4217 — Sterile water/saline, 500 ml ($2.18–$4.93)
- A4218 — Sterile saline or water, metered dose dispenser, 10 ml
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Next steps
- Run a reimbursement report for a device billed under A4226
- Watch A4226 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4226
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.